Current controversies and challenges in allergic rhinitis management

David Price¹, Pete Smith², Peter Hellings³, Nikos Papadopoulos⁴, Wytske Fokkens⁵, Antonella Muraro⁶, Ruth Murray⁷, Alison Chisholm⁸, Pascal Demoly⁹, Glenis Scadding¹⁰, Joaquim Mullol¹¹, Phil Lieberman¹², Claus Bachert¹³, Ralph Mösges¹⁴, Dermot Ryan¹⁵, Jean Bousquet^{16

17

18}

Affiliations

¹ a 1 Research in Real Life, Singapore, Singapore.
² b 2 Department of Clinical Medicine, Griffith University, Southport, Australia.
³ c 3 Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium.
⁴ d 4 Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
⁵ e 5 Department of Otorhinolaryngology, Academic Medical Center (AMC) Amsterdam, Amsterdam, The Netherlands.
⁶ f 6 Food Allergy Referral Centre, Veneto Region, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
⁷ g 7 Medscript (Scientific & Medical Affairs), Dundalk, Ireland.
⁸ h 8 Respiratory Effectiveness Group, Cambridge, UK.
⁹ i 9 Department of Pulmonology - Division of Allergy, University Hospital of Montpellier, Hôpital Arnaud de Villeneuve, France.
¹⁰ j 10 RNTNE Hospital, London, UK.
¹¹ k 11 Hospital Clinic, IDIBAPS, CIBERES, Barcelona, Catalonia, Spain.
¹² l 12 University of Tennessee College of Medicine, Memphis, USA.
¹³ m 13 Upper Airways Research Laboratory (URL), University Hospital Ghent, Ghent, Belgium.
¹⁴ n 14 Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany.
¹⁵ o 15 University of Edinburgh, Edinburgh, UK and Optimum Patient Care, Cambridge, UK.
¹⁶ p 16 University Hospital, Montpellier, France.
¹⁷ q 17 MACVIA-LR, Contre les Maladies Chronique spour un Vieillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, France.
¹⁸ r 18 INSERM, VIMA: Ageing and chronic diseases. Epidemiological and public health approaches, U1168, Paris, and UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France.

PMID: 26325631
DOI: 10.1586/1744666X.2015.1081814

Review

Current controversies and challenges in allergic rhinitis management

David Price et al. Expert Rev Clin Immunol. 2015.

. 2015;11(11):1205-17.

doi: 10.1586/1744666X.2015.1081814. Epub 2015 Aug 29.

Authors

Affiliations

¹ a 1 Research in Real Life, Singapore, Singapore.
² b 2 Department of Clinical Medicine, Griffith University, Southport, Australia.
³ c 3 Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium.
⁴ d 4 Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
⁵ e 5 Department of Otorhinolaryngology, Academic Medical Center (AMC) Amsterdam, Amsterdam, The Netherlands.
⁶ f 6 Food Allergy Referral Centre, Veneto Region, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
⁷ g 7 Medscript (Scientific & Medical Affairs), Dundalk, Ireland.
⁸ h 8 Respiratory Effectiveness Group, Cambridge, UK.
⁹ i 9 Department of Pulmonology - Division of Allergy, University Hospital of Montpellier, Hôpital Arnaud de Villeneuve, France.
¹⁰ j 10 RNTNE Hospital, London, UK.
¹¹ k 11 Hospital Clinic, IDIBAPS, CIBERES, Barcelona, Catalonia, Spain.
¹² l 12 University of Tennessee College of Medicine, Memphis, USA.
¹³ m 13 Upper Airways Research Laboratory (URL), University Hospital Ghent, Ghent, Belgium.
¹⁴ n 14 Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany.
¹⁵ o 15 University of Edinburgh, Edinburgh, UK and Optimum Patient Care, Cambridge, UK.
¹⁶ p 16 University Hospital, Montpellier, France.
¹⁷ q 17 MACVIA-LR, Contre les Maladies Chronique spour un Vieillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, France.
¹⁸ r 18 INSERM, VIMA: Ageing and chronic diseases. Epidemiological and public health approaches, U1168, Paris, and UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France.

PMID: 26325631
DOI: 10.1586/1744666X.2015.1081814

Abstract

There are many obstacles in the path of effective allergy management, in general, and allergic rhinitis (AR) control, in particular. Chief among them are: insufficient symptom relief in some patients provided by some currently considered first-line AR treatments in real life; an over-reliance on randomized controlled trials to direct AR guideline recommendations; the need for a broader interpretation of the AR evidence base (to include randomized controlled trials and real-life studies); poorly designed and interpreted studies; and lack of an AR control concept and common language of control. These controversies are fully reviewed here and challenging solutions have been presented.

Keywords: allergic rhinitis; clinical relevance; control; guidelines; randomized controlled trials; real life.

PubMed Disclaimer

Cited by

Hotspots and Trends in Allergic Rhinitis Nasal Mucosa Studies: A Bibliometric Analysis (2010-2024).
Wang M, Fu L, Wang H, Tian L. Wang M, et al. J Asthma Allergy. 2025 Mar 15;18:417-435. doi: 10.2147/JAA.S503477. eCollection 2025. J Asthma Allergy. 2025. PMID: 40115252 Free PMC article. Review.
A patient-centric analysis to identify key influences in allergic rhinitis management.
Cvetkovski B, Tan R, Kritikos V, Yan K, Azzi E, Srour P, Bosnic-Anticevich S. Cvetkovski B, et al. NPJ Prim Care Respir Med. 2018 Sep 13;28(1):34. doi: 10.1038/s41533-018-0100-z. NPJ Prim Care Respir Med. 2018. PMID: 30213945 Free PMC article.
Unmet Primary Physicians' Needs for Allergic Rhinitis Care in Korea.
Yang HJ, Kim YH, Lee B, Kong DY, Kim DK, Kim MA, Kim BS, Kim WY, Kim JH, Park Y, Park SY, Bae WY, Song K, Yang MS, Lee SM, Lee YM, Lee HJ, Cho JH, Jee HM, Choi JH, Yoo Y, Koh YI; Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology. Yang HJ, et al. Allergy Asthma Immunol Res. 2017 May;9(3):265-271. doi: 10.4168/aair.2017.9.3.265. Allergy Asthma Immunol Res. 2017. PMID: 28293933 Free PMC article.
Single nucleotide polymorphisms of IL-13 and CD14 genes in allergic rhinitis: a meta-analysis.
Chen ML, Zhao H, Huang QP, Xie ZF. Chen ML, et al. Eur Arch Otorhinolaryngol. 2018 Jun;275(6):1491-1500. doi: 10.1007/s00405-018-4975-7. Epub 2018 Apr 23. Eur Arch Otorhinolaryngol. 2018. PMID: 29687183
The Burden of Self-Reported Rhinitis and Associated Risk for Exacerbations with Moderate-Severe Asthma in Primary Care Patients.
Kritikos V, Price D, Papi A, Infantino A, Ställberg B, Ryan D, Lavorini F, Chrystyn H, Haughney J, Lisspers K, Gruffydd-Jones K, Román Rodríguez M, Høegh Henrichsen S, van der Molen T, Carter V, Bosnic-Anticevich S. Kritikos V, et al. J Asthma Allergy. 2020 Oct 6;13:415-428. doi: 10.2147/JAA.S266204. eCollection 2020. J Asthma Allergy. 2020. PMID: 33116650 Free PMC article.

See all "Cited by" articles

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Atypon
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Current controversies and challenges in allergic rhinitis management

Affiliations

Current controversies and challenges in allergic rhinitis management

Authors

Affiliations

Abstract

Similar articles

Cited by

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Research Materials

Abstract

Similar articles

Cited by

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Research Materials